Archives of Gynecology and Obstetrics

, Volume 286, Issue 4, pp 905–911

Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China

Maternal-Fetal Medicine

Abstract

Purpose

We aimed to investigate the combined associations of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes in Chinese women.

Methods

Data for 292,568 singleton term pregnancies were selected from 1993 to 2005 based on the Perinatal Health Care Surveillance System, with anthropometric measurements being collected prospectively. Prepregnancy BMI was categorized according to the definitions of the World Health Organization (WHO). Total GWG was categorized into four groups. Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated using logistic regression analyses. GWG was categorized as below, within and above the Institute of Medicine (IOM) (2009) recommendations.

Results

Maternal overweight and high GWG or GWG above the IOM recommendation were associated with hypertensive disorders complicating pregnancy, cesarean delivery, macrosomia and large-for-gestational-age (LGA) infants. Maternal underweight and low GWG or GWG below the IOM recommendation were risk factors for low-birth-weight (LBW) and small-for-gestational-age (SGA) infants. Moreover, being overweight [odds ratio (OR) 1.2, 95 % confidence interval (CI) 1.0–1.3) and having a low weight gain (OR 1.1, 95 % CI 1.0–1.1) increased the risk of newborn asphyxia.

Conclusion

Being overweight/obese and having a high weight gain, as well as being underweight and having a low weight gain, were associated with increased risks for adverse pregnancy outcomes in Chinese women.

Keywords

Gestational weight gain Body mass index Pregnancy Infant 

References

  1. 1.
    Berry RJ, Li Z, Erickson JD et al (1999) Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 341:1485–1490CrossRefPubMedGoogle Scholar
  2. 2.
    Cedergren M (2006) Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet 93:269–274CrossRefPubMedGoogle Scholar
  3. 3.
    Cedergren MI (2007) Optimal gestational weight gain for body mass index categories. Obstet Gynecol 110:764CrossRefGoogle Scholar
  4. 4.
    Chen Z, Du J, Shao L et al (2010) Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. Int J Gynaecol Obstet 109:41–44CrossRefPubMedGoogle Scholar
  5. 5.
    Cnattingius S, Bergstrom R, Lipworth L, Kramer MS (1998) Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 338:147–152CrossRefPubMedGoogle Scholar
  6. 6.
    Institute of Medicine (1990) Nutrition during pregnancy: part i, weight gain: part ii, nutrient supplements. National Academy Press, Washington, DCGoogle Scholar
  7. 7.
    Institute of Medicine (2009) Weight gain during pregnancy: reexamining the guidelines. The National Academies Press, Washington, DCGoogle Scholar
  8. 8.
    Jensen DM, Ovesen P, Beck-Nielsen H et al (2005) Gestational weight gain and pregnancy outcomes in 481 obese glucose-tolerant women. Diabet Care 28:2118–2122CrossRefGoogle Scholar
  9. 9.
    Joseph KS, Young DC, Dodds L et al (2003) Changes in maternal characteristics and obstetric practice and recent increases in primary cesarean delivery. Obstet Gynecol 102:791–800CrossRefPubMedGoogle Scholar
  10. 10.
    Kim SY, Dietz PM, England L, Morrow B, Callaghan WM (2007) Trends in pre-pregnancy obesity in nine states, 1993–2003. Obesity (Silver Spring) 15:986–993CrossRefGoogle Scholar
  11. 11.
    Li S, Moore CA, Li Z et al (2003) A population-based birth defects surveillance system in the People’s Republic of China. Paediatr Perinat Epidemiol 17:287–293CrossRefPubMedGoogle Scholar
  12. 12.
    Ma GS, Li YP, Wu YF et al (2005) The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Zhonghua Yu Fang Yi Xue Za Zhi 39:311–315PubMedGoogle Scholar
  13. 13.
    Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP (1999) The spread of the obesity epidemic in the United States, 1991–1998. JAMA 282:1519–1522CrossRefPubMedGoogle Scholar
  14. 14.
    Nohr EA, Bech BH, Vaeth M, Rasmussen KM, Henriksen TB, Olsen J (2007) Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort. Paediatr Perinat Epidemiol 21:5–14CrossRefPubMedGoogle Scholar
  15. 15.
    Nohr EA, Vaeth M, Baker JL, TIa S, Olsen J, Rasmussen KM (2008) Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 87:1750–1759PubMedGoogle Scholar
  16. 16.
    Sherrard A, Platt RW, Vallerand D, Usher RH, Zhang X, Kramer MS (2007) Maternal anthropometric risk factors for caesarean delivery before or after onset of labour. BJOG 114:1088–1096CrossRefPubMedGoogle Scholar
  17. 17.
    Stotland NE, Cheng YW, Hopkins LM, Caughey AB (2006) Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol 108:635–643CrossRefPubMedGoogle Scholar
  18. 18.
    Stotland NE, Hopkins LM, Caughey AB (2004) Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstet Gynecol 104:671–677CrossRefPubMedGoogle Scholar
  19. 19.
    Thorsdottir I, Torfadottir JE, Birgisdottir BE, Geirsson RT (2002) Weight gain in women of normal weight before pregnancy: complications in pregnancy or delivery and birth outcome. Obstet Gynecol 99:799–806CrossRefPubMedGoogle Scholar
  20. 20.
    Vahratian A, Siega-Riz AM, Savitz DA, Zhang J (2005) Maternal pre-pregnancy overweight and obesity and the risk of cesarean delivery in nulliparous women. Ann Epidemiol 15:467–474CrossRefPubMedGoogle Scholar
  21. 21.
    Young TK, Woodmansee B (2002) Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 187:312–318 (discussion 318–320)CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Epidemiology and BiostatisticsSchool of Public Health, Peking UniversityBeijingPeople’s Republic of China
  2. 2.Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive HealthPeking University Health Science CenterBeijingPeople’s Republic of China
  3. 3.Ministry of HealthBeijingChina
  4. 4.Editorial Office, Chinese Journal of OncologyCancer Hospital, Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Personalised recommendations